Southerners may not be the most obese in the U.S.

It goes against popular belief, but a recent study from the University of Alabama at Birmingham (UAB) shows that the southern region of the United States is not the fattest part of the country.

“The obesity epidemic is overwhelming the United States, and there’s this strong perception that Mississippi and Alabama are number one and number two in obesity—fighting for last place,” said George Howard, Professor in the Dept. of Biostatistics in the UAB School of Public Health.

Howard said that according to data from the long-running REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, the West North Central part of the country, which includes North and South Dakota, Minnesota, Nebraska, Iowa, Kansas, and Missouri, is the fattest area—with a 41% obese population. These findings were published in Obesity.

The study grouped states into regions used by the U.S. Census Bureau in order to compare data to the National Health and Nutrition Examination Survey (NHANES) to confirm the findings from REGARDS. Mississippi and Alabama are part of the East South Central region of the U.S., which also includes Tennessee and Kentucky. REGARDS ranked the region fifth out of nine regions with 34% obese, and the NHANES showed that it was seventh out of eight regions with only 31% obese (NHANES ranks fewer regions than REGARDS because NHANES has fewer measurements collected for reporting the New England states of Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut).

Also, both REGARDS and NHANES used data sets gathered from measured height and weight. Howard said the state-by-state obesity rankings typically cited are from data that used self-reported height and weight information.

Howard said it is important that obesity rankings be correct, as a lot rides on these numbers. “A lot of decisions are based on geographic differences in obesity—such as how much federal funding goes to regions to fight obesity. Typically, the South has received the most because others have said it’s the fattest, but it might not be. The South has had very bad obesity problems, but not worse than some other regions,” said Howard.